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Propecia Shows Hair Regrowth, With Few Side Effects
June 17, 1997
New data from three studies presented here today at the prestigious World
Congress of Dermatology show that Propecia(TM) (finasteride 1 mg), Merck
& Co. Inc.'s investigational oral treatment for men with male pattern
hair loss, prevented further hair loss in treated men and increased hair
growth in both frontal and vertex areas of the scalp in many men.
These new results broaden knowledge about the potential role for Propecia
in men with mild-to-moderate male pattern hair loss (androgenetic alopecia).
Data from two Phase III clinical trials of 1,553 men with predominant thinning
in the vertex (top of the head), presented earlier this year at the American
Academy of Dermatology, demonstrated significant improvement in hair in
men taking Propecia compared to those receiving a placebo.
In those studies, 86 percent of men maintained or showed an increase
in the amount of their hair based on hair counts during the course of the
studies, compared with 42 percent of men receiving placebo.
The application for Propecia is under review by the U.S. Food and Drug
Administration. Upon clearance, Propecia would be the first oral treatment
taken once-a-day for the prevention of further hair loss and for regrowth
in the most common sites of hair thinning in men. Upon marketing, it will
be indicated for use in men only.
In the first presentation of the Phase III frontal hair loss study results,
data show Propecia significantly increased frontal scalp hair counts from
baseline for patients taking Propecia compared to those taking placebo.
Cosmetic improvement was assessed by patients, investigators and an expert
panel of dermatologists who viewed patient photographs.
Results of this 12-month study of 326 men aged 20 to 41 with mild-to-moderate
frontal hair thinning show:
-- In the patient assessment, 53 percent of men with frontal hair loss
reported that treatment with Propecia led to an improvement in the appearance
of their hair, versus 30 percent of men taking placebo. Significant improvements
were seen in men as early as Month 3 and were generally maintained or improved
throughout the one-year study.
-- Clinical investigators rated 52 percent of patients treated with
Propecia as showing increased hair growth versus 31 percent of men treated
with placebo.
-- An expert panel of dermatologists evaluating patient photographs
rated 37 percent of patients treated with Propecia as having increased
hair growth. By comparison, only 7 percent of patients on placebo were
reported to show improvement.
Using another measurement technique in this trial, investigators reported
a significant improvement for men treated with Propecia compared to those
taking placebo in the hair density and pattern in three sections of the
scalp -- frontal, mid-area and vertex.
In this multicenter, randomized, double-blind, placebo-controlled study,
hair counts were measured in a representative 1 cm2 area of thinning hair
in the frontal scalp.
"The frontal study is unique because hair loss studies in men typically
evaluate hair growth at the vertex," said Keith Kaufman, M.D., senior
director, clinical research, Merck Research Laboratories, Rahway, NJ. "Frontal
thinning is commonly seen in men and it is what they may first notice when
they look in the mirror."
The frontal study results presented today are the third component of
the Phase III clinical trial program for Propecia, which has involved a
total of 1,879 men in the United States and worldwide.
Results of the studies with Propecia in preventing further hair loss
also were described. A comprehensive analysis of the two Phase III trials
on vertex hair loss confirmed that Propecia prevented further hair loss
in treated men. Hair loss in the placebo group was confirmed in each study
demonstrating the progressive natural history of the hair loss process.
Based on hair counts in the two 12-month studies of men with vertex
hair loss, only 14 percent of men in the group taking Propecia lost hair,
based on any decrease in hair count from baseline, while 58 percent of
men in the placebo group continued to lose hair. In the patient questionnaire,
68 percent of men taking Propecia reported that their hair loss had slowed
compared to 45 percent of those taking placebo. At Month 3, figures from
the patient questionnaire were 54 and 44 percent respectively.
In the frontal study, men treated with Propecia also reported that their
hair loss was slowing by Month 3 with 65 percent citing it by Month 12.
After a year, only 45 percent of men treated with placebo reported any
decrease in their hair loss.
Scientists believe that male pattern hair loss is genetically linked
and triggered by the presence of dihydrotestosterone or DHT. "The
ability to increase hair growth and prevent further hair loss, by specifically
lowering DHT with finasteride 1 mg, provides a potential new oral therapeutic
option with an excellent risk-benefit ratio for the treatment of men with
male pattern hair loss," Dr. Kaufman said.
Drug Very Well-Tolerated in Men
The tolerability of Propecia was reinforced by the new data. The drug
was very well tolerated, with most patients reporting no significant side
effects. In the Phase III studies of 1,879 men, the overall safety profile
for Propecia and placebo was similar.
Side effects were infrequent and occurred in a small number of men.
The only ones occurring in more than one percent of patients were decreased
libido (1.8 percent of patients treated with Propecia versus 1.3 percent
on placebo) and erectile dysfunction (1.3 percent Propecia versus 0.7 percent
placebo). Decreased volume of ejaculate was reported by 0.8 percent of
men treated with Propecia versus 0.4 percent of those taking placebo.
"For the overwhelming majority of men -- 96 percent -- who took
finasteride, ranging in age in our studies from 18 to 41, these side effects
were not reported," Dr. Kaufman noted. "These side effects were
reversible in men who discontinued therapy and even resolved in many of
these patients who preferred to continue treatment."
Contraindicated in Pregnant Women
Propecia is for use by men only. Women who are or may be pregnant must
not use Propecia, since it may cause a specific birth defect in a male
fetus (hypospadias).
Getting to the Root of the Problem
Propecia works by treating an underlying cause of male pattern hair
loss by inhibiting the production of DHT, which is believed to be a major
cause of hair loss. The enzyme Type II 5-alpha-reductase is involved in
the production of DHT. Propecia inhibits the action of Type II 5-alpha-reductase,
thereby decreasing DHT concentrations in treated men by approximately 60
percent.
"This approach represents an important advance in our understanding
of the science of hair loss," Dr. Kaufman commented. "Male pattern
hair loss is characterized by progressive miniaturization of hair follicles
and finasteride inhibits a key factor responsible for this miniaturization.
This leads to a reversal of the process of scalp hair loss in many men."
Merck submitted new drug applications beginning in December 1996 for
clearance to market Propecia worldwide. "If cleared for marketing,
we believe Propecia will be an important product as the first oral medication
for the treatment of men with male pattern hair loss," Dr. Kaufman
added.
Merck & Co. Inc., is a research-driven pharmaceutical products and
services company. Merck & Co. discovers, develops and markets a broad
range of innovative products to improve human health and quality of life.
SYDNEY, Australia
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